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Over the past 40 years, in an attempt to reduce the morbidity and mortality of altitude illness, a number of volunteer-run, seasonal aid posts have been established at mountain ranges across the world. As each aid post is designed for the local population and tourists at hand, the range of problems seen and services offered vary accordingly. Although each clinic differs on its funding model, the services it offers, how it is staffed, and the interventions available, there are key similarities between each of these clinics. For physicians preparing to travel from their home country to volunteer at such aid posts, there are important preparations that need to be made before embarking on such endeavors. This article describes how to prepare for such work, what to expect, and some of the challenges that one might face.

The I-allele rather than the D-allele of the human angiotensin converting enzyme (ACE) gene has been associated with high-altitude mountaineering success. We investigated whether the I-allele was associated with summit success, and also with AMS development, in altitude-naïve trekkers. Subjects ascended from 1,860 m to the summit over 4 days (n = 34, 'direct-profile') or 5 days (n = 82, 'slower-profile'). Proportionally more II direct-profile subjects were successful than ID or DD, although the difference was not significant (100% of II subjects, 52% ID and 43% DD, P = 0.09). There was no difference in success amongst subjects on the slower-profile (50% II, 45% ID and 58% DD, P = 0.54). There was a non-significant trend for increasing AMS scores in ID/DD subjects. Amongst tourist trekkers on Mt. Kilimanjaro the I-allele is not associated with summit success. No evidence is found to support an association between ACE genotype and AMS development.